Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters.
نویسندگان
چکیده
BACKGROUND Millions of peripheral intravenous catheters are used worldwide. The current guidelines recommend routine catheter replacement every 72-96 h. This practice requires increasing healthcare resource use. The clinically indicated catheter replacement strategy is proposed as an alternative. OBJECTIVES To assess the cost effectiveness of clinically indicated versus routine replacement of peripheral intravenous catheters. METHODS A cost-effectiveness analysis from the perspective of Queensland Health, Australia, was conducted alongside a randomized controlled trial. Adult patients with an intravenous catheter of expected use for longer than 4 days were randomly assigned to receive either clinically indicated replacement or third-day routine replacement. The primary outcome was phlebitis during catheterization or within 48 h after catheter removal. Resource use data were prospectively collected and valued (2010 prices). The incremental net monetary benefit was calculated with uncertainty characterized using bootstrap simulations. Additionally, value of information (VOI) and value of implementation analyses were performed. RESULTS The clinically indicated replacement strategy was associated with a cost saving per patient of AU$7.60 (95% confidence interval [CI] 4.96-10.62) and a non-significant difference in the phlebitis rate of 0.41% (95% CI -1.33 to 2.15). The incremental net monetary benefit was AU$7.60 (95% CI 4.96-10.62). The expected VOI was zero, whereas the expected value of perfect implementation of the clinically indicated replacement strategy was approximately AU$5 million over 5 years. CONCLUSION The clinically indicated catheter replacement strategy is cost saving compared with routine replacement. It is recommended that healthcare organizations consider changing to a policy whereby catheters are changed only if clinically indicated.
منابع مشابه
Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial.
BACKGROUND The millions of peripheral intravenous catheters used each year are recommended for 72-96 h replacement in adults. This routine replacement increases health-care costs and staff workload and requires patients to undergo repeated invasive procedures. The effectiveness of the practice is not well established. Our hypothesis was that clinically indicated catheter replacement is of equal...
متن کاملRoutine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial
OBJECTIVE To compare routine replacement of intravenous peripheral catheters with replacement only when clinically indicated. DESIGN Randomised controlled trial. SETTING Tertiary hospital in Australia. PARTICIPANTS 755 medical and surgical patients: 379 allocated to catheter replacement only when clinically indicated and 376 allocated to routine care of catheter (control group). MAIN OU...
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AIM The purpose of this study was to investigate the safety of clinically indicated peripheral intravenous catheters (PIVC) replacement intervals. BACKGROUND Peripheral intravenous catheters are used internationally, including in China where PIVCs are routinely replaced every 72 to 96 hours. Despite some recent international evidence showing such routine replacement is unnecessary, developing...
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Complications of Peripheral Intravenous Catheters During 72 Hours After Insertion
Introduction: Peripheral Intravenous catheterization is the most commonly used invasive treatment method in patients admitted to the hospitals, but it has some complications. The indwell time of catheter is one of the factors associated with the occurrence of complications, especially phlebitis. In spite of the instructions for replacing the catheters after 72 hours, sometimes the complications...
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ورودعنوان ژورنال:
- Applied health economics and health policy
دوره 12 1 شماره
صفحات -
تاریخ انتشار 2014